The present invention pertains to a type of emergency medical device or harness for use with an injured infant or small child, and its combination with a solid support, such as a backboard. More particularly, this invention pertains to a novel spinal immobilizer for an infant or a small child, and the novel means whereby such spinal immobilizer may be conveniently and effectively used with an adult size backboard.
In recent years, pediatric trauma has been receiving widespread attention, inasmuch as pediatric trauma is one of the leading causes of infant death. By pediatric trauma we mean to include not only automobile accident victims, but also infants and young children injured on bicycles, falls from trees, and from a wide variety of sporting accidents.
For these reasons, a considerable amount of current attention has been directed to the field of emergency medical care. This emphasis, at least in part, has arisen by reason of increased awareness that the chances for the successful recovery of a victim of an injury or ailment may be enhanced significantly through substantial improvement in the methods employed and the equipment utilized in retrieving the victim from an emergency situation, and transporting him or her to an appropriate medical facility. Such emphasis has led to the establishment of intensive training throughout the country of Emergency Medical Technicians (EMTs) and paramedics. At the same time, considerable effort has been devoted to the improvement and the expansion of the variety of kinds of equipment carried in ambulances, rescue vehicles and other emergency units.
One area of particular concern to us has been the removal and transportation of an accident victim who may have been subjected to severe physical forces effective against his or her back, neck and head. Because both motor and response functions normally associated by the layman with the brain actually involve the entire spinal column, it is possible that even comparatively slight physical damage to any portion of the spinal column may result in severe permanent impairment, or even death in the event of high cervical spine trauma. Moreover, it is all too easy, in removing and transporting a victim, to aggravate an initially simple and non-serious area of physical injury in such a way that permanent disability or death is inadvertently caused to occur.
One especially difficult removal problem often occurs in the case of vehicle accidents. A victim may be wedged behind portions of the vehicle that are bent and distorted, making it exceedingly difficult for the EMTs or paramedics to gain ready access. In that case, an attempt is usually made to insert a special device to provide support behind the back of the seated victim. Such a device is a short backboard approximately the size of the victim's upper torso, in terms of length and width. Then, the person or persons aiding the victim must attempt to weave long flexible straps in and around the short backboard and the victim even though often working in extremely tight quarters.
Thus it has been customary, whenever at all possible, to immobilize the entire spinal column prior to permitting or effecting the slightest movement of the upper torso, neck and head of victims who remain in a sitting position in their vehicle. To that end, one EMT usually gently but firmly immobilizes the head of the victim while the other attendant affixes a cervical collar, and then inserts the appropriate support behind or beneath the victim's backside. The previously mentioned long flexible straps, having buckles at one end, are then woven through slots provided along the side edges of the backboard, and criss-crossed behind the board and over the front of the upper torso of the victim, as well as around his or her upper thighs, in a manner to bind the victim immovably to the spinal support device. A separate harness assembly may be placed over the point of the chin and around the forehead and then tightly secured, now usually by means of Velcro fasteners, to an upper portion of the support device. When such an arrangement of straps and head harness is properly applied, the victim may then be removed and transported with greatly minimized risk of further injury. Analogous strapping approaches frequently are utilized in connection with the transport of a victim by means of a stretcher.
Injured infants and small children present an unusual problem in that the adult size backboards are much too large to be utilized with small persons, and most emergency vehicles do not have enough space to accommodate infant size backboards.
Unfortunately, the aforementioned short backboards used in connection with seated auto accident victims are not of the proper configuration to be used with badly injured infants and small children. Accordingly, we were motivated to design components enabling an emergency vehicle carrying only adult size backboards, to use such full size backboards in the safe and effective restraint of infants and small children that have been seriously injured.
We are aware of other devices in the general nature of our device, such as the Kendrick U.S. Pat. No. 4,211,218 entitled "Spinal Restraint Device."
As that patentee explains, a spinal restraint device is provided in the form of a body member having a head support portion, a neck support portion, and a back support portion. The back support portion and the neck support portion have a body wrap-around arm portion extending laterally from each of its sides. The body member has a front sheet-like layer of flexible material, a middle sheet-like layer of flexible material, and a rear sheet-like layer of flexible material. Laterally spaced longitudinal rows of stitching secure the front, middle, and rear sheet-like layers of flexible material together to form a plurality of longitudinal sleeves between the front sheet-like layer of flexible material and the middle sheet-like layer of flexible material. The longitudinal sleeves extend substantially across the entire width of the body member. Stiffener members are located within the longitudinal sleeves. The spinal restraint device has a pair of leg loop straps attached to the rear surface of the back support portion and a hoisting loop attached to the rear surface of the head support portion.
The Kendrick device, however, does not meet the need for a pediatric restraint device of the type indicated, for its use is limited to dealing with a victim remaining in a seated position.
We are also aware of a pediatric immobilization system advertised in the Fall 1987 Catalog bearing the title "CritiCare, " published by a division of Clark Surgical Corporation. On Page 35 of that catalog, a Pediatric Immobilization System bearing the tradename "Pedi-BacPac" is advertised, which is designed to slide over an existing adult backboard and instantly convert it to a pediatric immobilization system. Although such device has certain advantageous features for the immobilization of a pediatric trauma patient, it is not, by the clear wording of the advertisement, intended for infant immobilization. In addition, the Pedi-BacPac could not be taken into a wrecked vehicle to immobilize a badly injured child, to prevent it from flailing its limbs, for the Pedi-BacPac provides by itself no spinal support, and the cramped conditions of a wrecked vehicle may well not afford sufficient space for the accommodation of a full size backboard. Also, the Pedi-BacPac utilizes certain metallic components, which would not permit immediate x-ray of the patient, and that device also would prevent the application of CPR to a child needing same, and it further would prevent the application of a M.A.S.T. suit to the child restrained in the Pedi-BacPac.
Another prior art patent of which we are aware is the Peters U.S. Pat. No. 2,410,181, entitled "Stretcher," which issued on Oct. 29, 1946. Peters describes his device as being an elongate frame made of metal tubes enclosed in canvas. It is designed for carrying and moving people without regard to spinal injury, and has float members 22 disposed along the sides of the device. Peters uses flexible bands extending transversely across the stretcher and positioned to substantially encircle the portion of the body below the hips and above the knees. It can readily be used in place of an ordinary stretcher.
Importantly, Peters uses no distinct collar member, as used in one of the embodiments of this invention, and his closest approach to a collar member is the section of the canvas between parallel bands 4, which is seen to involve the front sheet-like layer of material referred to as canvas that happens to be under the patient's neck.
Head restraint pads utilized in the Peters patent are actually nothing more than parallel bands of flat material that are sewn onto the front near the head portion. They only act as a means to allow flexible strap 17 or any similar means to pass between the upper portions of bands. Unfortunately, the arrangement taught by Peters permits a highly undesirable side to side movement of the injured person's head, so his stretcher configuration entirely fails to properly immobilize the head of the injured person, even when the person may have a suspected cervical injury.
As will be seen hereinafter, the spinal immoblizer in accordance with the instant invention offers considerable resistance to bending to help prevent further spinal injury. The instant device is designed to be used with an adult size backboard and stretcher for maximum stabilization in the event the patient may have suffered spinal cord injuries. The distinct collar member in accordance with one embodiment of this invention is the rear portion of the spinal immobilizer near the head end, which allows the immobilizer to be attached to an intermediate member, or to the adult size backboard by hook and loop Velcro, or by any other suitable attachment means.
We describe hereinafter that the collar member used in accordance with one embodiment of our pediatric brace is significant in that it advantageously utilizes an attachment means for readily and easily securing our novel device directly to an adult size backboard, or to an intermediate piece.